Kontextuellt socialt kapital och ohälsa
Sammanfattning
Socialt kapital (SK) i relation till ohälsa är, trots det ökade intresse det rönt under senare tid, ett relativt outforskat område och det råder ännu oklarhet kring huruvida det kan påverka hälsan. Generellt sett har utvecklingen gått mot en mer diversifierad syn på SK. En mängd studier har visat på ett samband mellan SK och ohälsa, men i ett flertal studier har inget samband kunnat visas. En utvärdering av området försvåras av att SK mäts på olika sätt samt av att olika mycket hänsyn tagits till confounders. Resultaten som presenteras här bygger på forskning som bedrivs på avdelningen för folkhälsoepidemiologi inom projektet ”Socialt kapital och ohälsa i Stockholms län” (SOCKA). Vi visar ett samband mellan brist på kontextuellt SK och dålig självskattad hälsa, men detta samband blir svagare och försvinner till slut vid justering för olika individuella och kontextuella faktorer. Huruvida det finns ett svagt eller inget samband alls beror på i vilken utsträckning individuellt SK ska ses som en confounder eller en medierande faktor. Vi planerar två ytterligare studier inom kort där vi kommer att undersöka dels kontextuellt SK och mortalitet och dels individuellt och kontextuellt SK i relation till psykisk ohälsa.
Social capital (SC) in relation to health is, despite the increased attention it has attracted lately, a relatively young research field, and there is still uncertainty with regard to its effect on health. Generally, the trend has been towards a more diversified conceptual perspective. Although a large number of studies have shown an association between SC and ill-health, some others have not. Evaluation in the field is hindered by the conflating of the various aspects and dimensions of SC, and by the problem of residual confounding. The results presented here are based on research conducted at the division of Public Health Epidemiology, within the project “Social Capital and Ill-Health in Stockholm County”. We show an association between lack of contextual SC and poor self-rated health, an association that becomes weaker and finally disappears after adjustment for different individual and contextual factors. Whether there is no or a moderate association, depends on the extent to which individual SC is seen as a mediator or confounder. We plan two more studies in the near future where we will look at contextual SC and mortality in one, and individual and contextual SC in relation to mental ill-health in the other.
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